title: Haitian variant ctxB producing Vibrio cholerae O1 with reduced susceptibility to ciprofloxacin is persistent in Yavatmal, Maharashtra, India, after causing a cholera outbreak.
abstract: Vibrio cholerae O1 biotype El Tor producing Haitian variant Cholera Toxin (HCT) and showing reduced susceptibility to ciprofloxacin caused a cholera outbreak associated with a high case fatality rate (4.5) in India. HCT-secreting strains responsible for severe cholera epidemics in Orissa (India), Western Africa and Haiti were associated with increased mortality. There is a pressing need for an integrated multidisciplinary approach to combat further spread of newly emerging variant strains. The therapeutic effect of ciprofloxacin was diminished whereas use of doxycycline in moderate to severe cholera patients was found to be effective in outbreak management.
authors.affiliation: Jawaharlal Nehru University, New Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Kumar
authors.forename: D K
authors.initials: DK
authors.lastname: Mishra
authors.forename: D G
authors.initials: DG
authors.lastname: Deshmukh
authors.forename: M
authors.initials: M
authors.lastname: Jain
authors.forename: A M
authors.initials: AM
authors.lastname: Zade
authors.forename: K V
authors.initials: KV
authors.lastname: Ingole
authors.forename: P K
authors.initials: PK
authors.lastname: Yadava
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics*; D002771:Cholera / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D002772:Cholera Toxin / Q000235:genetics; D002939:Ciprofloxacin / Q000494:pharmacology; D027081:DNA Gyrase / Q000235:genetics; D027101:DNA Topoisomerase IV / Q000235:genetics; D004196:Disease Outbreaks; D052978:Disk Diffusion Antimicrobial Tests; D004318:Doxycycline / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000235:genetics; D006801:Humans; D007194:India / Q000453:epidemiology; D041241:Vibrio cholerae O1 / Q000187:drug effects* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D002939:Ciprofloxacin; D002772:Cholera Toxin; D027101:DNA Topoisomerase IV; D027081:DNA Gyrase; D004318:Doxycycline
keywords: Hatian variant cholera toxin; ciprofloxacin; doxycycline and outbreak; multidrug-resistance